Clinical Topic: According to research, a primary reason individuals come to the emergency department (ED) is to obtain relief from pain. The use of Patient Controlled Analgesia Pumps (PCA) in our Emergency Department has never been tried. We wanted to explore the feasibility and cost effectiveness of using the pumps in the ED setting. In addition, we wanted to evaluate patient and nurse satisfaction in using this device. A PCA is a device which allows self-administration of intravenous analgesia with physician-established dose parameters.

Implementation: The diagnosis of pain from kidney stone/renal colic was chosen to be evaluated. We selected morphine as the drug used in the PCA test. We gathered data comparing traditionally nurse administered intravenous medication as compared to the PCA patient administration. We also developed an educational program for nurses who had no prior experience using PCA pumps.

Outcomes: After careful cost comparison, we found that we could save time and money using PCA pumps. Our calculations included both delivery methods, and included calculating the cost of regular IV supplies, the time it took for a nurse to prepare the medication, remediate the patient, the PCA supplies, initial set up, and patient administration. For a patient who received four doses of nurse-medicated morphine, the cost was $110.40, compared to a cost of $47.91 for four doses of self-administered morphine. The total savings for the patient-administered pain was $62.49.

Recommendations: The use of PCA pumps in the ED is still being evaluated. The patients stated the pumps were easy to use, and they believed they had some control over their needs for analgesia. Our nursing staff found this method of analgesia safe, effective, and less time consuming. We also noted that we had more satisfied patients. We have focused on a very narrow group of patients, with only one specific drug. Additional investigation needs to be done to explore other applications for expanded PCA use in the emergency setting. [Clinical Poster Presentation]

<table><tr><td colspan="2" class="item-title">Patient Controlled Analgesia Pumps in the Emergency Department: An Evaluation of Cost Effectiveness, Nurse and Patient Satisfaction</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1998</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Luckenbaugh, Amy, RN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">York Hospital</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, York, PA, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Kay Bleecher, RN, BSN, CEN</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: According to research, a primary reason individuals come to the emergency department (ED) is to obtain relief from pain. The use of Patient Controlled Analgesia Pumps (PCA) in our Emergency Department has never been tried. We wanted to explore the feasibility and cost effectiveness of using the pumps in the ED setting. In addition, we wanted to evaluate patient and nurse satisfaction in using this device. A PCA is a device which allows self-administration of intravenous analgesia with physician-established dose parameters.<br/><br/>Implementation: The diagnosis of pain from kidney stone/renal colic was chosen to be evaluated. We selected morphine as the drug used in the PCA test. We gathered data comparing traditionally nurse administered intravenous medication as compared to the PCA patient administration. We also developed an educational program for nurses who had no prior experience using PCA pumps.<br/><br/>Outcomes: After careful cost comparison, we found that we could save time and money using PCA pumps. Our calculations included both delivery methods, and included calculating the cost of regular IV supplies, the time it took for a nurse to prepare the medication, remediate the patient, the PCA supplies, initial set up, and patient administration. For a patient who received four doses of nurse-medicated morphine, the cost was $110.40, compared to a cost of $47.91 for four doses of self-administered morphine. The total savings for the patient-administered pain was $62.49.<br/><br/>Recommendations: The use of PCA pumps in the ED is still being evaluated. The patients stated the pumps were easy to use, and they believed they had some control over their needs for analgesia. Our nursing staff found this method of analgesia safe, effective, and less time consuming. We also noted that we had more satisfied patients. We have focused on a very narrow group of patients, with only one specific drug. Additional investigation needs to be done to explore other applications for expanded PCA use in the emergency setting. [Clinical Poster Presentation]</td></tr></table>

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dc.date.available

2011-10-27T10:34:07Z

-

dc.date.issued

2011-10-17

en_GB

dc.date.accessioned

2011-10-27T10:34:07Z

-

dc.description.sponsorship

Emergency Nurses Association

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